Does the US shoot itself in the foot by presenting a lack of choice?

[annettemarie]

The "Do you vaccinate" thread made me think of this. We haven't vaccinated our three youngest at all, mostly due to a lack of choice. We object to the vaccines that were originally cultured on fetal cells, but it's very difficult to get separated vaxes here in the US, despite them being available elsewhere. We also don't have the versions of the vaccinations that weren't cultured on fetal tissue here in America. The exemption here in PA is an "all or nothing" exemption, so we end up not getting the ones we wouldn't take issue with. And even without the moral issues, I still would want to give vaccinations on a more spread out schedule. But I can't because again, so many are combined.

In countries with more choices/more respect for parental autonomy, what are the vax rates like? Would more people choose to vaccinate if they were given more choice and say in the matter? I would be a lot more likely to vaccinate if I could get them separated, be exempt from the ones that violate my religious beliefs, and do it on a schedule I was comfortable with.

Just curious as to what everyone thinks. We still haven't done any for Daniel, and with the new babies here, it reminds me that we really do need to make a decision.

[zinemama]

I wasn't aware that other countries routinely separate vaxes (you're talking about something like a separate M, M and R, for example?) or versions of vaccines not originally cultured on fetal cells. What countries are those?

My hunch is that the number of non-vaxing parents who would vaccinate if those things were available is very small, hardly worth making an effort for, from a public health perspective.

Giving vaccines on a more spread out schedule, however, is something I have never had a problem with any pediatrician about.

[annettemarie]

It was my understanding that separated vaxes were more readily available in other countries and that the US manufacturers don't make them because it would be cost prohibitive to do so. I could be wrong though.

I know that in 2000 I was able to get the MMR separated, but in 2004 it would have been over $150 for each individual component and insurance wouldn't cover it.

[annettemarie]

I was looking for least objectionable link on the alternative vaccines, as I really didn't want this to turn into a religious debate.

“The FDA has the authority to allow for the licensing and importation of safe and effective ethical alternative vaccines such as Takahashi (rubella) and Aimmugen (Hepatitis A), and it has a moral duty to exercise that authority," Saxer added.

http://www.catholicnewsagency.com/news/catholic_doctors_call_for_vaccines_not_derived_from_aborted_fetuses/

So yes, they do exist. The FDA just won't approve them.

[miriam]

It has been my understanding that other nations of the world are not are authoritarian as American doctors regarding vaccines. Cultural difference? While there are exemptions here in America, how many parents know that, and how many doctors respect a parent's choice to delay or not vaccinate?  

I do know that the polio epidemic ended in America and Europe at the same time, however, Europe did not push the vaccine as much as the American medical establishment.  Americans were ready to give the credit to the vaccine.  In Europe, the polio epidemic, as many epidemics of the past, was simply over. 

I lived through that era.  I do not really care how or who is writing the history now. I know and remember the facts.

Edited by miriam - 3/14/11 at 4:24pm

[Turquesa]

Great thread topic!  This same question has been spinning in my mind.  I have no data because I'm not sure which countries are rigid v. lax about vaxes.  But I can at least answer anecdotally.

For example, I know that there's a push to combine vaccines, a practice hailed by physicians as a way to lessen the needle jabs.  But what if I don't want some of the vaccines in that cocktail?  Honestly, it's likely that if I were put in that sort of all-or-nothing position, I'd opt for nothing.  If I'm given a choice, at least I'll get something.   

Another example: I like to separate out the vaccines to ensure that if there is an allergic reaction, I'll know which shot caused it.  The problem is that my insurance won't cover multiple visits to the doctors office, and our county health department harasses parents who deviate from CDC doctrine.  I promise this isn't to sound arrogant, but from a public health perspective, aren't they lucky that I'm there at all?  If they'd back off and nix the harassment, I'd be getting more vaccines.

Finally, those of us who've read The Vaccine Book by Robert Sears have a list of vaccine brands that are low in aluminum.  When I requested these brands, my doctor told me that it was impossible because "We just get what the state sends us."  No other clinic or pharmacy in town carried these brands.  So consumers aren't allowed a choice in product.  The result?  I ended up getting fewer vaccines for my children. 

These are just three of many examples.  If officials take public health half as seriously as they claim, they will give parents more choices....and likely see higher vax compliance as a result.

[crunchy_mommy]

I think (just my opinion here!) that vax rates are so high here because of the lack of choice (as well as the lack of understanding that there IS a choice, if choices are available). I have heard people say they weren't able to opt out of individual vaxes so they just got them all. I've heard others say they thought it was a law that you HAVE to vaccinate and it HAS to be on schedule. And most doctors in the US don't give their patients choices so everyone just does it.

For me, personally, however, there are vaxes I would consider using if they were available, affordable, safe, and ethical, as well as work within the framework of the state exemptions. I can absolutely see the value in a rubella vax for a woman nearing child-bearing age, for ex., but I do not want to use something grown on fetal cells, nor do I want the measles & mumps components, so I would likely choose just to forgo the vax altogether (moot point since I got the vax as a kid, just wanted to use your example). My impression, however, is that the number of people who feel strongly either way is such a small percentage of the population, that offering these choices very well would be cost-prohibitive and unlikely to make an impact on overall vax rates. It seems that a large portion of the unvaxed aren't necessarily consciously choosing not to vax (rather, circumstances make it less likely that they will get the vaxes, so if anything, the laws and free vaxes and a set schedule helps them to stay on track)...

[miriam]

<For me, personally, however, there are vaxes I would consider using if they were available, affordable, safe, and ethical, as well as work within the framework of the state exemptions. I can absolutely see the value in a rubella vax for a woman nearing child-bearing age, for ex., >

I do too.  

However, ~

Did you know that for decades most OB/GYNs refuse the boosters for MMR because they know the crippling side effects will put them out of work.  AND they are the ones who are around pregnant women every day because that is their job.  So, my feeling is, why bother?  If they think the vaccine is too dangerous, then why should I bother with the vaccine and/or boosters?  If you do not believe me, ask ACOG.  They know about it, yet do nothing.

[crunchy_mommy]

Originally Posted by miriam 

<For me, personally, however, there are vaxes I would consider using if they were available, affordable, safe, and ethical, as well as work within the framework of the state exemptions. I can absolutely see the value in a rubella vax for a woman nearing child-bearing age, for ex., >

I do too.  

However, ~

Did you know that for decades most OB/GYNs refuse the boosters for MMR because they know the crippling side effects will put them out of work.  AND they are the ones who are around pregnant women every day because that is their job.  So, my feeling is, why bother?  If they think the vaccine is too dangerous, then why should I bother with the vaccine and/or boosters?  If you do not believe me, ask ACOG.  They know about it, yet do nothing.

Yeah, I definitely believe you, that's why I put "safe" in there Unfortunately, most of the diseases I feel are worth avoiding, don't have safe vaxes, which basically sums up my reasons for not vaxing at all... Very frustrating!

[mcgee]

I would love to have the option of separate out vaccines, rather than giving three or more in one injection. Why is pertussis combined with diptheria and tetanus, when diptheria is so rare in the US? Why can one get a separate tetanus shot (as I was given several years ago), but not a separate pertussis shot? If it's such a vital public health need to have as many people vaccinated against pertussis as possible, why not make a single shot available??

We are fortunate that we live in a state with a broad philosophical exemption, and this allows us to delay/selectively vaccinate as we and our children's pediatrician feel appropriate. I feel awful for families who live in states that force them to take an all or nothing approach.

[zinemama]

Originally Posted by miriam 

Did you know that for decades most OB/GYNs refuse the boosters for MMR because they know the crippling side effects will put them out of work.

Do you have a link or source for this statement?

[LisaSedai]

Feb. 20, 1981, issue of the Journal of the American Medical Association, an article entitled “Rubella Vaccine in Susceptible Hospital Employees, Poor Physician Participation” reports that the lowest vaccination rate among medical personnel for the German measles vaccine occurred among obstetrician/gynecologists and the next lowest rate occurred among pediatricians.16 The authors conclude, “The fear of unforeseen vaccination reactions was the main reason for the low uptake rate of physicians to be vaccinated.”

http://www.vaccinetruth.org/doctor1.htm

Here is some info about Swiss doctors from 2005 on vaccinating their own children

http://www.cure-guide.com/Natural_Health_Newsletter/Doctors_Decline_Vaccines/doctors_decline_vaccines.html

[Otto]

Originally Posted by LisaSedai 

Feb. 20, 1981, issue of the Journal of the American Medical Association, an article entitled “Rubella Vaccine in Susceptible Hospital Employees, Poor Physician Participation” reports that the lowest vaccination rate among medical personnel for the German measles vaccine occurred among obstetrician/gynecologists and the next lowest rate occurred among pediatricians.

Here.

A serosurvey of 2,456 high-risk employees of the Los Angeles County-University of Southern California Medical Center showed that 345 (14%) were susceptible to rubella. Of 197 seronegative personnel followed up for participation in a vaccination program, 105 (53.3%) were vaccinated. However, only one of the 11 known susceptible obstetrician-gynecologists was vaccinated.

February and March 1979. A bit shy of the "for decades" and "most" parts.

[miriam]

Originally Posted by zinemama 

Originally Posted by miriam 

Did you know that for decades most OB/GYNs refuse the boosters for MMR because they know the crippling side effects will put them out of work.

Do you have a link or source for this statement?
 

I love how everyone on the internet wants a source for every single statement.  In my full, original post, I suggested to to ask ACOG.  

This has been a well-known concern of all organizations medical including ACOG and CDC for decades.  The CDC complains that problem puts a crimp in their vaccine program.  Dr. Mendelsohn mentioned this fact many times in his books, lectures and interviews. I have had the good fortune to be a young mother and be able to meet with Dr. Mendelsohn many times.  If Dr. Mendelsohn were lying about this, quackwatch would mention this or a libel or slander suit would have been filed.  McNeil, PPC filed libel charges against Mendelsohn when Mendelsohn said that cyanide was part of the production process and that residues of this chemical could remain in the final product and this caused the Tylenol scare of 1981.

OTTO - your link is from 1981, and the rubella vaccine was required around ~1971~, so yes, as long as the rubella vaccine has been around and required for health care workers and especially healthcare workers who are around pregnant women - and - since medicine discovered that boosters would be needed since the initial vaccine campaign in 1967 promised that one shot was all anyone needed for lifelong immunity to rubella; quite presumptuous.  Yes, I recall posters from that era.  I am that old.  

How many pregnant women have been unsuspectingly exposed to rubella since the early 1971s by their OBs, and never knew?  Those OBs are also keeping the mothers' records.  If there is a problem, does the doctor write it in the patients' record and what does the doctor write?

Or ask your own OB/GYN and ask HIM for evidence of HIS vaccine or the veracity of my statement.  I am sure he is more trustworthy than I ever could be.  

Edited by miriam - 3/17/11 at 12:08pm

[Otto]

Originally Posted by miriam 

OTTO - your link is from 1981, and the rubella vaccine was required around ~1971~, so yes, as long as the rubella vaccine has been around and required for health care workers and especially healthcare workers who are around pregnant women - and - since medicine discovered that boosters would be needed since the initial vaccine campaign in 1967 promised that one shot was all anyone needed for lifelong immunity to rubella; quite presumptuous.

I'm honestly having a hard time making heads or tails of this. I provided the 1981 article that was referenced in the preceding post. "Yes," what? Obviously, rubella vaccination wasn't required for health-care workers, and... it's not a sentence. "Go ask ACOG" isn't a support for the original assertion.

[Jugs]

^^Plus health care workers are generally given then the option of taking the vaccine or submitting proof of immunity; I hardly consider it "refusing" the vaccine when an antibody titer shows it may not be needed.

[miriam]

ACOG and the CDC clearly say that obstetricians and gynecologists refusal of the rubella vaccine because of its well-known side effects as a problem in promoting the government vaccination program.  

So, yes, ask the experts, ACOG; get your information from them.    

I am obviously too dumb to write a complete sentence. Do not trust me.  Trust your doctor.

[Otto]

Originally Posted by miriam 

ACOG and the CDC clearly say that obstetricians and gynecologists refusal of the rubella vaccine because of its well-known side effects as a problem in promoting the government vaccination program.

Where? I don't think this is an unreasonable question.

[PlayaMama]

Originally Posted by miriam 

ACOG and the CDC clearly say that obstetricians and gynecologists refusal of the rubella vaccine because of its well-known side effects as a problem in promoting the government vaccination program.  

So, yes, ask the experts, ACOG; get your information from them.    

I am obviously too dumb to write a complete sentence. Do not trust me.  Trust your doctor.

in the article cited didn't it say "fear of unforeseen vaccination reactions"? that doesnt' equate to well-known side effects...

but in response to the original question, i'm not sure if it would increase vaccination rates if there were more vaccines offered. it didn't make a difference for me as the ones that are combined are all ones that i want to get anyway.